Possibilities for Shortening the CAHPS Clinician and Group Survey

Stucky, Brian D.; Edelen, Maria Orlando; Gurvey, Jill; Brown, Julie A.

doi:10.1097/mlr.0000000000000452

Cited by 17 publications

(21 citation statements)

References 14 publications

(10 reference statements)

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“…The aggregate scale maintained the validity of the longer composite, with scores remaining highly correlated with overall satisfaction with the provider. 38 Our study confirms use of these 2 items to assess HPRQ.…”

Section: Discussionsupporting

confidence: 82%

“…These items were also most strongly correlated with overall satisfaction with the provider. A recent study by Stucky et al 38 has shown that an aggregate scale of 2 CG-CAHPS items, “spending enough time” with the patient and “listening carefully” to the patient, provides nearly equivalent measurement precision as the longer Doctor Communication composite scale in which they are embedded. The aggregate scale maintained the validity of the longer composite, with scores remaining highly correlated with overall satisfaction with the provider.…”

Section: Discussionmentioning

confidence: 99%

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Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions

Eton

Ridgeway

Linzer

et al. 2017

PPA

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PurposeHaving multiple chronic conditions (MCCs) can lead to appreciable treatment and self-management burden. Healthcare provider relational quality (HPRQ) – the communicative and interpersonal skill of the provider – may mitigate treatment burden and promote self-management. The objectives of this study were to 1) identify the associations between HPRQ, treatment burden, and psychosocial outcomes in adults with MCCs, and 2) determine if certain indicators of HPRQ are more strongly associated than others with these outcomes.Patients and methodsThis is a cross-sectional survey study of 332 people with MCCs. Patients completed a 7-item measure of HPRQ and measures of treatment and self-management burden, chronic condition distress, self-efficacy, provider satisfaction, medication adherence, and physical and mental health. Associations between HPRQ, treatment burden, and psychosocial outcomes were determined using correlational analyses and independent samples t-tests, which were repeated in item-level analyses to explore which indicators of HPRQ were most strongly associated with the outcomes.ResultsMost respondents (69%) were diagnosed with ≥3 chronic conditions. Better HPRQ was found to be associated with less treatment and self-management burden and better psychosocial outcomes (P<0.001), even after controlling for physical and mental health. Those reporting 100% adherence to prescribed medications had higher HPRQ scores than those reporting less than perfect adherence (P<0.001). HPRQ items showing the strongest associations with outcomes were “my healthcare provider spends enough time with me”, “my healthcare provider listens carefully to me”, and “I have trust in my healthcare provider”.ConclusionGood communication and interpersonal skills of healthcare providers may lessen feelings of treatment burden and empower patients to feel confident in their self-management. Patient trust in the provider is an important element of HPRQ. Educating healthcare providers about the importance of interpersonal and relational skills could lead to more patient-centered care.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions

Eton

Ridgeway

Linzer

et al. 2017

PPA

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“…Clinical primary care settings often turn to patient experience surveys, such as the Clinician and Group Consumer Assessment of Healthcare Providers and Systems, that researchers have recently sought to shorten in order to increase its use. 26 Patient experience measures focus important attention on the consumer experience of care delivery and receipt of services, but fall short of focused attention on the broad scope of primary care. 1,15 Needed is a measure, grounded in the combined experiences of patients, clinicians, and payers, that engages the most informed reporter-the patient-to assess vital functions of primary care that are lost by current reductionist measures.…”

Section: Introductionmentioning

confidence: 99%

A New Comprehensive Measure of High-Value Aspects of Primary Care

et al. 2019

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PURPOSE To develop and evaluate a concise measure of primary care that is grounded in the experience of patients, clinicians, and health care payers.METHODS We asked crowd-sourced samples of 412 patients, 525 primary care clinicians, and 85 health care payers to describe what provides value in primary care, then asked 70 primary care and health services experts in a 2½ day international conference to provide additional insights. A multidisciplinary team conducted a qualitative analysis of the combined data to develop a parsimonious set of patient-reported items. We evaluated items using factor analysis, Rasch modeling, and association analyses among 2 online samples and 4 clinical samples from diverse patient populations. RESULTSThe resulting person-centered primary care measure parsimoniously represents the broad scope of primary care, with 11 domains each represented by a single item: accessibility, advocacy, community context, comprehensiveness, continuity, coordination, family context, goal-oriented care, health promotion, integration, and relationship. Principal axes factor analysis identified a single factor. Factor loadings and corrected item-total correlations were >0.6 in online samples (n = 2,229) and >0.5 in clinical samples (n = 323). Factor scores were fairly normally distributed in online patient samples, and skewed toward higher ratings in point-of-care patient samples. Rasch models showed a broad spread of person and item scores, acceptable item-fit statistics, and little item redundancy. Preliminary concurrent validity analyses supported hypothesized associations. CONCLUSIONSThe person-centered primary care measure reliably, comprehensively, and parsimoniously assesses the aspects of care thought to represent high-value primary care by patients, clinicians, and payers. The measure is ready for further validation and outcome analyses, and for use in focusing attention on what matters about primary care, while reducing measurement burden.

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“…Both NCQA and the CAHPS Consortium have conducted research to re-evaluate the PCMH survey, and, as of the time of this present study, have each put forth their own proposals for changes to the survey [ 11 , 15 ], with the CAHPS Consortium finalizing their revised version of the CAHPS Clinician and Group survey (version 3.0) in July 2015, reducing the length from 34 to 31 items [ 12 ]. Additional possibilities for shortening the CAHPS Clinician and Group survey have also since been published [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, in the months since NCQA initiated its evaluation, the CAHPS Consortium also released a slightly shorter version of the CAHPS Clinician and Group survey (version 3.0), which forms the core of the CAHPS PCMH survey, reducing the length from 34 to 31 items [ 11 , 12 ]. Additional possibilities for shortening the CAHPS Clinician and Group survey were also published recently [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Shortening a Patient Experiences Survey for Medical Homes

Henry

Oberlander

et al. 2015

Healthcare

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The Consumer Assessment of Healthcare Providers and Systems—Patient-Centered Medical Home (CAHPS PCMH) Survey assesses patient experiences reflecting domains of care related to general patient experience (access to care, communication with providers, office staff interaction, provider rating) and PCMH-specific aspects of patient care (comprehensiveness of care, self-management support, shared decision making). The current work compares psychometric properties of the current survey and a proposed shortened version of the survey (from 52 to 26 adult survey items, from 66 to 31 child survey items). The revisions were based on initial psychometric analysis and stakeholder input regarding survey length concerns. A total of 268 practices voluntarily submitted adult surveys and 58 submitted child survey data to the National Committee for Quality Assurance in 2013. Mean unadjusted scores, practice-level item and composite reliability, and item-to-scale correlations were calculated. Results show that the shorter adult survey has lower reliability, but still it still meets general definitions of a sound survey for the adult version, and resulted in few changes to mean scores. The impact was more problematic for the pediatric version. Further testing is needed to investigate approaches to improving survey response and the relevance of survey items in informing quality improvement.

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Possibilities for Shortening the CAHPS Clinician and Group Survey

Cited by 17 publications

References 14 publications

Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions

Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions

A New Comprehensive Measure of High-Value Aspects of Primary Care

Shortening a Patient Experiences Survey for Medical Homes

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